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Newborn Weight Gain

Hi, I have a question about weight gain. My husband took my daughter to her 2 week appointment today and was told that since she is not back to her birth weight, she needs to be fed 2 ounces every 2 hours. I had to go into work today, I am school teacher and needed to get my room set before my long term sub starts next week, which is why my husband took her. Needless to say he did not ask all of the questions I would have. How does this work when the infant is being nursed? Obviously my husband has been giving her bottles of BM while I am away. She still lataches and nurses just fine for me, I don't give her the bottle. How does one measure 2 ounces when a baby is nursing? Should I just nurse every 2 hours? What if she refuses to nurse so frequntly, should I bottle feed with bm?

Re: Newborn Weight Gain

Welcome to the forum and congratulations on the new baby!

When a baby is 2 weeks old and hasn't yet regained her birthweight, that is cause for taking a good hard look at breastfeeding and figuring out what is going on. There are some perfectly innocuous reasons for a baby being slow to gain, like differences in calibration between scales or baby being weighed in a diaper and clothes at one visit and in the nude at the next. Also, if the mom had IV fluids during her birth, that can result in a birthweight which is artificially inflated.

If you can rule all those possibilities out, then you come up against another set of possible explanations for slow weight gain. A poor latch, a tongue tie, an excessively sleepy or jaundiced baby, a slow start to milk production, mom limiting time at the breast or nursing according to a schedule- those are all common causes for slow weight gain. I suggest seeing a lactation consultant, preferably an IBCLC, for help in figuring out if any of those possibilities are at fault.

Some questions for you:
- How does nursing feel? Any pain, blistering, cracking?
- How often does baby nurse in a 24 hour period?
- Does baby often fall asleep at the breast, perhaps within a short time of beginning to nurse?
- When baby nurses, do you hear lots of swallowing?
- When did you notice your milk coming in?
- When baby poops, what color are the poops? And how many times a day does baby produce a poop?

If you must supplement, then you want to do the following:
- See an IBCLC
- Nurse more often
- Supplement with your own milk, not formula
- Supplement in a breastfeeding-friendly way (i.e. probably not with a bottle, since bottle introduction is supposed to be delayed until 4-6 weeks- sorry I don't know if this jibes with your return to the workplace!)-
- Possibly use a professional baby scale (you can probably rent this from your IBCLC), so that you can do before and after nursing weights, allowing you to know when baby has taken in sufficient milk at the breast and does not require a supplement

Re: Newborn Weight Gain

i totally agree with mommal. I would also suggest, call your doctor and get clarification-how poor has baby's gain been, exactly? 2 ounces every two hours would add up to 24 ounces a 24 hour day-in other words, baby's entire needed daily intake at this age. If you supplement anywhere near this much, your baby will not need to nurse at all, and may not, and that means bye bye milk production, unless you also pump for every feeding. That gets exhausting very fast. A two week old baby should be getting *about* two ounces per nursing session. (it normally varies a bit.) But that assumes breastfeeding is going well. Your answers to mommals questions will help you figure that out.

as far as nursing every two hours, a two week old baby needs to nurse a minimum of 10-12 times a day. minimum. It does not have to be every two hours, neccesarily, as many babies cluster feed-they feed every hour or so, part of the day, and in that case the occasional longer stretch is fine.

Do you have other kids? if not, what about your husband coming with you to work when you are doing things like setting up the classroom or meeting with other adults (ie, not actually teaching) so you can nurse as needed? just for these early days, it is vital to nurse (or pump, with an excellent pump)very frequently to get nursing off to a great start. If you cannot nurse due to separations, you have to pump.

Re: Newborn Weight Gain

I called the doctor today. Her instructions for the 2 ounces every 2 hours were for my husband to feed our daughter while I have to work this week. She told me to keep nursing, just to wake her up more frequently, I have a sleepy baby that likes to sleep for 4 hour blocks Apparently she thinks she is a teenager with all of this sleeping! Despite having bottles while I am at work she is still a super nurser, both days that I came home from work she was ready to nurse as soon as she saw me. We are thinking that her not being back to birth weight has something to do with all of her sleeping and last week when my milk came in I had a huge overproduction! I was able to freeze 6 bags of milk last week on top of nursing every 3 to 4 hours. She was having trouble latching and staying latched because there was so much milk (she was choking on it, getting sprayed in the face, etc) I had to pump before I could nurse her or she wouldn't be able to latch!

Re: Newborn Weight Gain

oh yeah, oversupply is drag. It's early days, good chance it will calm down on its own. Watch the pumping prior to nursing, as 'extra' pumping might increase supply! You can do it if that works best for you, just watch how much. So great baby is such a good little nurser!

Re: Newborn Weight Gain

My first born was a terrible nurser (I also had ppd so that honestly probably contributed to our issues.) I ended up pumping non-stop for 3 months with him. I don't mind some extra pumping so that when I am back at work full time I will have plenty to send to our care provider. I just didn't want to have to do the round-the-clock pumping again! It was an uber pain! Very relieved my daughter is a good little nurser!